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BJA Advance Access originally published online on December 24, 2004
British Journal of Anaesthesia 2005 94(3):347-351; doi:10.1093/bja/aei056
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004. All rights reserved. For Permissions, please e-mail: journal.permissions{at}oupjournals.org

PAIN

The preoperative administration of ketoprofen improves analgesia after laparoscopic cholecystectomy in comparison with propacetamol or postoperative ketoprofen

G. Boccara1,*, A. Chaumeron2, Y. Pouzeratte2 and C. Mann2

1 Department of Anaesthesiology and Critical Care, Hospital Saint-Joseph, Paris, France. 2 Department of Anaesthesiology and Critical Care, Hospital Saint-Eloi, Montpellier, France

* Corresponding author: Département d'Anesthésie-Réanimation, Hôpital Saint-Joseph, 185 Rue Raymond Losserand, 75674 Paris Cedex 14, France. E-mail: gboccara{at}hopital-saint-joseph.org

Background. Non-opioid analgesics, paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) are proposed for pain relief after laparoscopy. We compared perioperative propacetamol (P) and ketoprofen (K) to provide analgesia after laparoscopic cholecystectomy.

Methods. After ethical committee approval, we included 104 ASA I–II patients, without preoperative analgesic drugs, who were scheduled to undergo laparoscopic cholecystectomy. Anaesthesia was standardized using propofol, fentanyl, atracurium, isoflurane and N2O 50%. Ketoprofen 100 mg or propacetamol 2 g or a saline drip (a 100-ml unit of saline in 10 min) was infused blindly and randomly. Patients received either ketoprofen (group K1) or propacetamol (group P1) before induction of anaesthesia and saline after surgery, or saline before surgery and ketoprofen (group K2) or propacetamol (group P2) after surgery. Postoperative visual analogue pain scores (VAS 0–100 mm) were recorded during 24 h. If VAS was >30, a second dose (placebo, ketoprofen or propacetamol) was infused. Nalbuphine 0.2 mg kg–1 i.v. was given as rescue analgesic if VAS was ≥50.

Results. Ninety-eight patients were studied The number of patients not requiring the second analgesic was greater in K1 (33.5%) than the others (K2 0%, P1 0%, P2 7.5%). VAS scores were significantly lower in K1 (P=0.001), with less nalbuphine consumption compared with P1. VAS and opioid request were similar in K2 and P2.

Conclusion. Preoperative administration of ketoprofen improves postoperative analgesia after laparoscopic cholecystectomy compared with its postoperative administration and pre- and postoperative propacetamol.


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